Part I was published in Can J Plast Surg 2000;8(1):25–29. It established that standards of professional practice shift constantly. When a standard falls short of professional expectation or when a physician becomes more concerned with financial gain rather than patient care, society needs the action of a reformer.
Part II continues the study and begins with the contribution of reformer John Hunter (1728–1793), and follows with the contributions of seven other reformers, concluding with Wilder Penfield (1891–1976).
Study Design
The reformers were physicians and scientists who were selected throughout the history of medicine: they conformed to our definition of reformers, namely, a person whose action changed the structure or ideology of medical practice.
Results
The present historical article shows that reforms are produced by people possessing critical judgement and analytical quality who influenced the direction of medical practice.
Conclusion
Reforms have been achieved through intuitive leaps, alterations of conventional practice, painstaking research or administrative restructuring.
BeekmanF. The self-education of young John Hunter. J Hist Med1951; 6: 506–15.
2.
DobsonJ. John Hunter.Edinburgh: E & S Livingstone, 1969: 33–4.
3.
JarchoS. John Hunter on inflammation. Am J Cardiol1970; 26: 615–8.
4.
QvistG. John Hunter's alleged syphilis. Ann R Coll Surg1977; 59: 205–9.
5.
HunterI. Syphilis in the illness of John Hunter. J Hist Med1953; 8: 249–62.
6.
KoblerJ. The Reluctant Surgeon: A Biography of John Hunter.New York: Doubleday, 1960: 232–8.
7.
BrainR. The neurology of John Hunter's last illness. BMJ1952; ii:1371–3.
8.
PagetJ. Memoires and Letters.London: Longman, 1902: 286.
9.
RandallJ. The influence of Edinburgh Medical School in America in the 18th century. Edinb Med J1923; 30: 95–124.
10.
Great Britain.Evidence, Oral and Documentary. Commission appointed by His Majesty George IV, July 23, 1826 for the visiting of the universities of Scotland.London: W Clowes and Sons, 1837.
11.
PasteurL. Dépôts qui se forment dans les vins. Acad Sci (Paris) C R1865; 60: 1109–13.
12.
FisherR. Joseph Lister, 1827–1912.London: Macdonald and Jane's, 1977: 135–6.
13.
FisherR. Joseph Lister, 1827–1912.London: Macdonald and Jane's, 1977: 146.
14.
ListerJ. On the effects of the antiseptic system upon the general salubrity of a surgical hospital. Lancet1870; i:4–6, 40–2.
15.
ListerJ. Further evidence regarding the effects of the antiseptic treatment upon the salubrity of a surgical hospital. Lancet1870; ii: 287–9.
16.
FischerR. Joseph Lister, 1827–1912.London: Macdonald and Jane's, 1977: 273.
17.
ArchibaldE. The mind and character of Lister. Can Med Assoc J1936; 35: 489.
18.
ThomHH. Johns Hopkins: A Silhouette.Baltimore: The Johns Hopkins Press, 1929: 102–3. (The full test of Hopkins’ last will and testament is herein reproduced).
19.
ThomHH. Johns Hopkins: A Silhouette.Baltimore: The Johns Hopkins Press, 1929: 90.
20.
FlexnerS, FlexnerJT. William Henry Welch and the Heroic Age of American Medicine.New York: The Viking Press, 1941: 92–3.
21.
OslerW. The evolution of internal medicine. In: McGovernJP, RolandCG, eds. The Collected Essays of Sir William Osler, vol 2. The Educational Essays.Alabama: The Classics of Medicine Library, 1985: 303–22.
22.
OslerW. The Principles and Practice of Medicine Designed for the Use of Practitioners and Students of Medicine.New York: D Appleton & Co, 1892.
23.
CroweSJ. Halsted of Johns Hopkins: The Man and His Men.Illinois: Charles C Thomas, 1957: 29.
24.
WhippleAO. Halsted's New York period. Surgery1952; 32: 548.
25.
CroweSJ. Halsted of Johns Hopkins: The Man and His Men.Illinois: Charles C Thomas, 1957: 37–59.
26.
CurtisFB. Howard A Kelly. Johns Hopkins Med Bull1943; 73: 1–22.
27.
FlexnerA. I Remember; The Autobiography of Abraham Flexner.New York: Simon and Schuster, 1940: 65.
28.
ShryockRH. The Unique Influence of the Johns Hopkins University on American Medicine.Copenhagen: Ejnar Munksgaard, 1953: 10.
29.
NorwoodWF. Medical education in the United States before 1900. In: O'MalleyCD, ed. The History of Medical Education.California: University of California Press, 1970: 484–92.
30.
FlexnerA. I Remember; The Autobiography of Abraham Flexner.New York: Simon and Schuster, 1940: 115.
31.
JacobsonTC. Making Medical Doctors: Science and Medicine at Vanderbilt Since Flexner.Alabama: University of Alabama Press, 1987: 37.
32.
FlexnerA. Medical Education in the United States and Canada, 1910: 28–51.
33.
FlexnerA. I Remember; The Autobiography of Abraham Flexner.New York: Simon and Schuster, 1940: 131.
34.
HudsonRP. Abraham Flexner in Perspective: American Medical Education 1865–1910. Bull Hist Med1972; 46: 545–61.
35.
NulandSB. Doctors: the Biography of Medicine.New York: Random House, 1989: 427.
36.
OslerW. Brief Description of the Physiological Laboratory, McGill College. Canada Med Surg J1880–81; 9: 198–201.
37.
MacmillanC. McGill and its Story 1821–1921.London: John Lane, 1921: 262.
38.
SegallHN. The four G's of the class of McGill medicine, class of 1916. Can Jew Hosp Soc J1982; 6: 17–32.
39.
FyeWB. The origin of the full-time faculty system. JAMA1991; 265: 1555–62.
40.
Letter from William Osler to Herbert Stanley Birkett, Dean of Medical Faculty, McGill University, 29 July 1919. (Osler Library Acc 326/1.6/Birkett)
41.
CushingH. The Life of Sir William Osler. Oxford: Clarendon Press, 1925; 2: 664.
42.
SegallH. Taped Interview with Dr Martin Entin, Royal Victoria Hospital, Montreal, 26 November 1986.
43.
LewisDS. Royal Victoria Hospital 1887–1947.Montreal: McGill University Press, 1969: 171.
44.
EntinM. The dynamics of research at the Royal Victoria Hospital, Montreal. Can J Surg1987; 30: 449–50.
45.
WherrettGJ. The Miracle of the Empty Beds: A History of Tuberculosis in Canada.Toronto: University of Toronto Press, 1977.
46.
ArchibaldE. The present status of surgery in pulmonary tuberculosis. Can Med Assoc J1913; 3: 1087.
47.
ArchibaldE. Recent advances in thoracic surgery. Can Med J1924; 14: 240.
48.
EntinM. Romance and tragedy of tuberculosis: Edward Archibald's contribution to the surgical treatment of pulmonary tuberculosis. Can J Plast Surg1995; 3: 213–6.
49.
MartinC. Letter to RM Pearce of Rockefeller Foundation, 7 December, 1928.
50.
PenfieldW. No Man Alone; A Neurosurgeon's Life.Boston: Little, Brown & Co, 1977: 3.
51.
PenfieldW. A medical student's memories of the Regius Professor. Bulletin of the International Association of Medical Museums and journal of technical methods. No 9. Sir William Osler Memorial Number. Montreal (Privately issued), 1926: 387.
52.
JosephD, ed. American Practice of Surgery; A Complete System of the Science and Art of Surgery.New York: W Wood & Co, 1906–1911.
53.
MeakinsJC. William Archibald Edward. Can Med Assoc J1946; 54: 194–7.
54.
PenfieldW. No Man Alone; A Neurosurgeon's Life.Boston: Little, Brown & Co, 1977: 295–6.
55.
PenfieldW. No Man Alone; A Neurosurgeon's Life.Boston: Little, Brown & Co, 1977: 383.
56.
FeindelW. The Montreal Neurological Institute. J Neurosurg1991; 75: 821–2.
57.
FeindelW. Wilder Penfield (1891–1976); The man and his work. Neurosurg1977; 1: 98.
